Obstetrical table with pivotal table top



June 29, 1954 F. H. HOWARD OBSTETRICAL TABLE WITH PIVOTED TABLE TOP 4 Sheets-Sheet l Filed March 29, 1952 IN V EN TOR. FOR/#sar H. HOWARD June 29, 1954 F. H. HOWARD 2,682,437 A OBSTETRICAL TABLE WITH PIVOTED TABLE TOP Filed March 29, 1952 4 Sheets-Sheet 2 1N VEN TOR. FOR/REST H. Hom/ARD YQQMSCQM ATTY.

June 29, 1954 Filed March 29, 1952 F. H. HOWARD OBSTETRICAL TABLE WITH PIVOTED TABLE TOP 4 Sheets-Sheet 5 FoRR/fsr H. How/R0 June 29, 1954 F. H. HOWARD OBSTETRICAL TABLE WITH PIVOTED TABLE TOP Filed Maren 29, 1952 I 4 Sheets-Sheet 4 Irs--l E INVENTOR.

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Patented June 29, 1954 UNITED STATES OFFICE lOBSTETRICAL TABLE WITH PIVOTAL TABLE TOP 7 Claims.

This invention relates to obstetrical tables and more particularly to a portable obstetrical chairtable combination that is adapted to provide the natural position in each phase of parturition.

An object of the invention is to provide improved means in a portable obstetrical chairtable for placing the patient in a physiological position that will promote the maximum voluntary and involuntary muscular force in a patient for the expulsion of fetus, embryo or feces, and take full advantage of gravity by adding the weight of the emerging infant or fecal material to said muscular force.

Another object of the invention is to provide improved means for varying the relative position of the body-supporting section of the chair-table as may be required for each procedure in parturition, said body-supporting section being rotatable substantially through 90 degrees to and from the horizontal and vertical positions.

Another object of the invention is to provide improved means for providing maximum safety, ease and convenience for the patient and staff throughout each phase of parturition, which object is achieved by a combination obstetrical chair-table that is further structurally combined with an obstetrical cart, and thereby the combination is adapted to convey the patient to and from the delivery room with minimum transfers.

Various other objects and advantages will be apparent as the nature of the invention is more fully disclosed.

In the accompanying drawings are shown the novel features and construction of one embodiment of the device disclosed according to the present invention.

Fig. l is a plan view of one form of the portable obstetrical chair-table, showing the supine position of a patient while being transferred from labor room to the delivery room;

Fig. 2 is a left side elevation of the device, showing combination thigh and lknee crutches and arm braces positioned with respect to the body-supporting section, preparatory to placing the limbs of the patient thereon as required to provide the correct physiological position for the patient during delivery;

Fig. 3 is a right side elevation of the device, showing the body-supporting section rotated to approximately vertical position as required to take full advantage of gravity during delivery;

Fig. 3A is an enlarged fragmentary horizontal sectional view of a supporting pinion for said body-supporting section taken along the line E3-I3 of Fig. 3;

Fig. 4 is a front elevation of the device, again showing the patient in correct physiological position for delivery;

Fig. 5 is a rear elevation of the device, showing certain details of construction;

Fig. 6 is a fragmentary vertical sectional view of the foot-supporting section taken along the line M-Ui of Fig. 4;

Fig. 7 is an enlarged detail longitudinal sectional view of the dual-acting hydraulic jack approximately along the line I5-l5 of Fig. 5;

Fig. 7A is an enlarged fragmentary transverse sectional detail view of a supporting-pinion for the hydraulic jack taken along the line ifi-I6 of Fig. 3;

Fig. 8 is an enlarged fragmentary transverse sectional detail view taken along the line il-I'l of Fig. 7, showing pump valves for one end of the opposed hydraulic pump;

Fig. 9 is an enlarged fragmentary transverse sectional view taken along the line IB--IS of Fig. 7, showing certain details of the opposed hydraulic pump;

Fig. 10 is an enlarged fragmentary sectional view taken along the line 20-20 of Fig. 7, showing longitudinal details of the crank shaft for said opposed hydraulic pump;

Fig. l1 is an enlarged fragmentary transverse vertical sectional View taken along the line 2 i-2 I of Fig. 3, showing a rotatable arm support for the rear end of the body-supporting section in the horizontal position;

Fig. 12 is an enlarged fragmentary View of an interior detail of the locking means for positioning said rotatable arm support shown in Fig. l1; and

Fig. 13 is a fragmentary longitudinal sectional view of the piston for the dual-acting hydraulic jack.

In the following description certain specic terms are used for convenience in referring to various details of the invention. These terms, however, are to be given as broad interpretation as the state of the art will permit.

Referring now more particularly to the accompanying drawings, wherein like and corresponding parts are designated by similar reference characters the letter B designates the rotatable body-supporting section, the letter F the footsupporting section, the letter C the conveyance section.

In the embodiment of the invention disclosed numerals 22 represent the tubular frame of the body section B, a pad 23 provides a cushion for the body of the patient, and a rigid lattice 24,

secured to the inner sides and forward end of said frame, provides support for said pad and said patient, the positions of said patient being indicated by dotted lines 25. Longitudinal bars 26 and 21, depending from the forward portions of the sides of said frame and secured to the same by welding, are provided with longitudinal slots 28. The patient-supporting standards 29 and 30 extend through said slots 28 when said standards are attached to said bars.

Said standards are secured rigidly to the outer parts of said bars by means of clamps 3| and 32 and screws 33 andA 34, as shown Figs. 1 to 5 inclusive. The combination thigh and knee crutches 35 and arm braces 38 are modified and improved forms of the common adjustable accessories, and it is important that said standards 29, which support said crutches 35, have a rectangular cross-section, in order to sustain the torsional forces produced by the weight of the patient upon said crutches. Each crutch 35 is provided with a conical forward extension 39 from the thigh-supporting portion, and said extension terminates in a ball 48, the latter being adapted to be adjustably secured by the forward end of a clamp 4|. The opposite end of said clamp 4| being adapted to clamp rigidly upon the transverse part of said standard 29, by means of the clamp screw 42 and lever 43. Extension clamps 44 are secured to the underside of arm braces 36, and by means of screws 45 and levers 46 said braces are adjustably secured to the ball ends 41 of said standards 38. 'I'he forward ends of said bars 26 and 21 are bored to receive screws 48 that secure the transverse pinion shaft 49 between the forward ends of Said bars.

A conveyance section C consists of side frames 59 and 5|, transverse portions 52, means for supporting said body-supporting section B and said foot-supporting section F, means for supporting a rotating means for said section B, and means for supporting position controls for said sections B and F, described as follows:

Said body-supporting section B is pivotally connected by said shaft 49 to bearings 53 and 54, best shown Fig. 3A, and said bearings support said section B in all rotated positions, however, the rotatable arms 55 and 56 may be used to support the rear end of said section B in the substantially horizontal position. Pairs of vertical plates 51 and 58, secured to said side frames 58 and by welding, provide support for said footsupporting section F and for means that control the position of same relative to said body-supporting section B. Vertical plates 59, secured to said side frames by welding, provide support for the dual-acting hydraulic jack and conjunctive members by means of the transverse portions 98 and bolts 8|, the latter best shown Fig. 7A.

Said foot-supporting section F, best shown Fig. 6, consists of a tubular frame 62, a lattice 69, secured within said frame by welding, a pad 84 supported by said lattice and front and rear pairs of horizontal transverse shafts 85 and 58 are secured to said frame 82 by parts depending from each corner of same. Front and rear pairs of inclined links 91 and 88 have their upper ends respectively connected to shafts 65 and 66. The lower ends of said links are pivotally connected respectively at 99 and 18 to the angle-bars 1i and 12. The latter are rigidly connected at their forward ends by transverse portions 13 and 14 to form a frame that is reciprocable in rollways consisting of a lower row of anti-friction rollers and 16 and an upper row of shorter rollers 11 and 18, said rollers being supported by said pairs of vertical plates 51 and 58. In the lower position of said section F said links 61 and 88 rest upon said transverse portions 13 and 1'4, as indicated by dotted lines 13 and 14' respectively, and in said lower position said shafts and 66 travel in a horizontal direction indicated by line 19. The lowered foot-supporting section F is automatically raised to the aligned position with respect to said body-supporting section B by the following mechanism: On the inner sides of said pair of plates 51 are secured cams having open upward curved slots 88 and 8|. Rear transverse projections 82 and 83 from said pair of links 58 have outwardly projecting roller-equipped studs 84 and 85. In the lower position of said section F the path of travel of said studs 34 and 85 coincides with the lower open ends of said slots 88 and 8|, however, as the end of forward movement of said section F approaches, said rollerequipped studs enter said slots 88 and 8| as indicated by dotted lines 86, and the path of movement of said studs is constrained by the curve of said slots. Said slots 88 and 8| are curbed substantially as shown to reduce shock at the end of said forward movement of said section F, and whereby said upper pinionsl 65 and S8 are constrained to move along the paths indicated by the curved dotted lines 81 and 88.

Said foot-supporting section F is automatically locked in said aligned position by the following means: Vertical arms 89 are secured to the outer sides of said bars 1| and 12, as shown Fig. 6, and which are adapted to be engaged by pawls 98 and 9| pinioned to the inner sides of said bars 26 and 21. Said pawls are retained in position for engaging said arms by compression springs 93, however, when said body-supporting section B is rotated from a lowered position said pawls are carried upward to position indicated 9|, Fig. 3, thereby releasing said arms 89, and whereby said section F falls to the lower position by force of gravity. According to the requirements of each operative position, the attending physician pushes said section F to safety position, indicated by full lines, Fig. 3, or to the out-of-way position indicated by dotted lines 68.

A dual-acting hydraulic jack and conjunctive parts provide means for rotating said body-supporting section B to and from lower and upper positions, this mechanism consists of the following parts: An hydraulic cylinder 94 having ports 95 and 96 at the ends, a piston rod guide 91 threaded to engage the outer end of said cylinder and adapted to secure an hydraulic leather 98, best shown Fig. '1, a piston rod 99 terminating at its outer end in an eye |88, and a double-acting piston secured to the opposite end of said rod 99. Said piston consisting of the parts |8| and |82, and opposed hydraulic leathers |83 and |84 secured between said parts |8| and |82. Said cylinder 94 being pinioned to said side frames 58 and 5| by means of transverse extensions 68, a pair of pinion bolts 6| and said side plates 59, the latter being best shown Fig. 7A.

Fluid under pressure is supplied to said jack by means of an hydraulic pump section P afxed to said cylinder 94 as follows: Opposed pistons |88 and |89 that are integral with a Scotch-yoke ||8, said pistons having pump leathers and ||2. A pair of intake and outlet valves consist of balls I3 and ||4 and conjunctive compression springs ||5 and ||8 of common forms. The outlets are connected by the pipe ||1 and both being connected directly to the four-way control cock I9. Pipe I 9 leads from said four-way cock H8 to the rear port 96 of said cylinder 94, and pipe |29 leads from said four-way cock ||8 to said forward port 95. Pipe |2| leads from said cock IIB and has branches |22 and |23 leading to said intake valves H3. A riser pipe |24 from said branch |23 has a nller cap |25, useful for putting fluid into system in a common manner.

Said four-Way cock H8 is of common form, except it has a stem 3i that extends outwardly to said side frame 5|, and terminates in a lever |25. When said lever is in vertical position as indicated Fig. 2, by dotted lines |25', fluid under pressure is directed by said four-way cock H8 via said pipe H9 to said rear port Q6, Fig. 7, and returning iiuid from said port 55, via pipe |29, is directed to said pipe |2|, as indicated by arrow |21, Fig. 7, and whereby said piston rod 99 is caused to move in an outward direction, as indicated by arrow 38. When said lever is placed in a horizontal position, indicated Fig. 2 by full lines |26, fluid under pressure is directed to said outer port 95 via said pipe |29 and fluid is returned from said port 95 Via said pipe ||9 via said valve H8 to said pipe |2| and to said intake valves H3, whereby said piston rod 99 is caused to move in a direction opposite to said arrow 98.

Said pump pistons |28 and |119 are actuated by a crank pin |28 carried by the crank shaft |29, best shown in Fig. 10. Said crankshaft extends outwardly to said side frame 5|, and has a crank wheel |39 secured to its outer end. Said crank may be turned in either direction, and the rate of movement of said piston rod 99 is in proportion to velocity of said crank.

The eye |99 of piston rod 99 is pinioned by the bolt |3| to the fork |92, the latter being integral with a bar |33 which is secured by welding to said bars 25 and 21 and said frame 22, best shown Fig. 5.

To provide for necessary stability of said: bodysupporting section B in an upper position, such as shown Fig. 3, the side frames of said conveyance section C are extended forward as shown at i343 and |35, however, said extensions |94 and |35 are spread apart, as shown Figs. l to 5, inclusive, to provide convenient access to the front of the chair-table for attending physician and sta-iT. The leg sections |39 and |371 are provided with brake-equipped casters |39 and |39 of coml inercial type, preferably of the type where the brake shoe may be placed in off-position by pressing in the direction of the arrow M9, Fig. 2, and be placed in ori-position by pressing in the direction of arrow lfil, Fig. 3.

Storage for accessories such as said standards 29 and 39, crutches 35, braces 36, and conjunctive items is provided by the lattice basket |52, which is attached to said conveyance section C by means of detachable clips |43.

In order to provide immediate access to the sides of said table, the controls for said means of rotation for said body-supportingr section are grouped on one side of said conveyance section and protrude no more than is required to make them accessible. However, the more important novel improvements are provided by the combination of rotatable body-supporting section B, conveyance section C, adjustable foot-supporting' section F, and the novel means for rotating said section B to and from lower and upper positions.

Normally, the procedure in using the chairtable is as follows: As the time for delivery approaches, the chair-table is wheeled into the labor-room; the rotatable arms and 56 are locked in the vertical position, as shown by full lines Fig. 11, and the body-supporting section B placed in the substantially horizontal position, as shown Figs. 1 and 2; and the patient is placed in the supine position as indicated by dotted lines 25, Fig. l. To receive the hypodermic injection, the arm of the patient may be supported by an arm brace as shown at 3S, Fig. l, however, the patient may assume a sitting posture (not shown) to receive the spinal anaesthesia as directed by attending physician. When the chairtable is wheeled to the delivery room, the standards 29 and Sil are clamped to the bars 29 and 21, and the crutches 35 and braces 3G are attached to their respective standards, the position of these supporting parts being adjusted to suit the patient as indicated Fig. 2. At the inception of delivery, the patients legs are placed on the crutches 35, the arms are placed on the braces 39, the body-supporting section B is pivoted from the horizontal position to the delivery position, as indicated Fig. 3, and the foot-supporting section F is pushed back to the safety position by attending physician, as shown Fig. 3. The pivoting of section B is accomplished in the l following manner:

The valve control lever is placed in the vertical position, indicated by dotted lines 26', Fig. 2, and the crank |39 is turned at a rate that will cause the body-supporting section B to rise from the lower position at a desired rate. The bodysupporting section B is pivoted from an upper position to a lower position by placing the valve control lever in the horizontal position, indim cated by full lines |29, and the crank |39 turned at a rate that will cause the section B to descend at a desired velocity.

When desired the section B may be placed in a still lower position in the following manner: The rotatable arms 55 and 5d are unlocked by swinging the latch |44 fromv the notch |45 and swing the same to position indicated by dotted lines Hifi', Fig. l2, place the arms 55 and 56 in the r rotated position indicated by dotted lines 55' and 56', Fig. 1l, and which may be locked in this rotated position by placing the latch ILM within the second notch |46 in the annular part Ii'i which is secured to the upper longitudinal portions of the side frames 5|! and 5|. The range of pivotal movement of the body-supporting section B is limited by the direction of the force applied by the piston rod 99 in its lowest position, as follows: When section B` is placed substantially in the horizontal position, as indicated by dotted lines 22', Fig. 3, the direction of force applied at the lower position of the piston rod 99 is indicated by the center line |48, and when section B is placed in a still lower position indicated by dotted lines 22', the direction of force applied at the still lower position of the piston rod 99 is indicated by the center line 49. The range of pivoting of section B being thus limited by the direction of the force applied by the piston rod in its lowest position.

The construction of each of the sections in the combination that constitutes the invention may vary, and such modications as come within the scope of the appended claims are deemed to be a part of the present invention.

I claim:

1. An obstetrical table for posturing the patient during parturition, comprising a conveyance frame, a body supporting frame pivotally connected at one end to said conveyance frame,

means for pivoting said body frame from a substantially horizontal position to a substantially vertical position and return as required, a pair of patient arm supports, means adjustably connecting said arm supports to said body frame for supporting the patients arms with said body frame in a vertical position, a pair of patient leg supports, means adjustably connecting said leg supports to said body frame for supporting the patients legs with said body frame, a foot support and means for adjustably connecting said foot support to said body frame.

2. An obstetrical table for posturing the patient during parturition comprising a conveyance frame formed of two substantially parallel side frames rigidly connected by transverse portions and having front and rear leg sections, a shaft extending between the upper forward ends of said side frames, front and rear pairs of vertical plates secured to the upper portions of said side frames, a lower pair of vertical plates secured to the lower portions of said side frames, a body-supporting frame having its forward end pivotally connected to said shaft, a bearing secured to the underside of said body-supporting section, means for sustaining the weight of the patient when said bodysupporting section functions as an obstetrical chair for supporting the back of said patient, extensible means for pivoting said body-supporting frame substantially through 90 degrees to and from its horizontal and vertical positions, the extensible member of said pivoting means being pivotally connected to said bearing, the body member of said pivoting means being pivotally connected to said lower pair of vertical plates, a foot-supporting section, means for positioning said foot-supporting section with respect to said body-supporting section, roll-ways for carrying said foot support and secured to the inner sides of said front and rear pairs of vertical plates, and said means for positioning said foot-supporting section being secured to the inner sides of said front pair of vertical plates.

3. An obstetrical table for posturing the patient during parturition comprising a conveyance frame formed of two substantially parallel side frames rigidly connected by transverse portions, front and rear legs, a pair of arms extending forwardly from the lower portions of said side frames, said rear legs being connected to the opposite lower end portion of said frame, and having said front legs connected thereto, said forward arms being spaced apart substantially wider than said side frames, a. shaft extending between the upper forward ends of said side frames, front and rear pairs of vertical plates secured to the upper portions of said side frames, a lower pair of vertical plates secured to the lower portions of said side frames, a body-supporting frame having its forward end pivotally connected to said shaft, a bearing secured to the underside of said body-supporting frame, means for supporting the patient in a squatting posture when said bodysupporting frame is in a substantially vertical position, extensible means for rotating said bodysupporting frame substantially through 90 degrees to and from its horizontal and vertical positions, the extensible member of said pivoting means being pivotally connected to said bearing, the body member of said pivoting means being pivotally connected to said lower pair of vertical plates, a foot-supporting member and means for positioning said foot-supporting member with respect to said body-supporting frame.

4. An obstetrical table for posturing the patient during parturition comprising a conveyance frame formed of two substantially parallel side frames rigidly connected by transverse portions, said side frames having front and rear leg sections, front and rear pairs of vertical plates secured to the upper portions of said side frames, a lower pair of vertical plates secured to the lower portions of said side frames, horizontally aligned supports extending from the upper forward ends of said side frames, a body-supporting frame consisting of a frame approximately rectangular in contour and having a rigid lattice secured to the inner sides and forward end of said frame, a longitudinal bar depending from each side of said frame, said bar having series of longitudinal slots extending therethrough with the axes of said slots being approximately perpendicular to the plane of said lattice and the spaces between said slots being approximately equal to the width of said slots, a transverse shaft secured between the forward ends of said bars, said shaft being positioned within said horizontally aligned supports, a bearing secured to the underside of said rotatable frame, means for sustaining the weight of the patient when said body-supporting frame is in its substantially vertical position for supporting the back of said patient, extensible means for pivoting said bodysupporting frame substantially through degrees to and from its horizontal and vertical positions, the extensible member of said means being pivotally connected to said bearing and the body member of said means being pivotally connected to said lower pair of vertical plates, a foot-supporting member, and means for positioning said foot-supporting member with respect to said body-supporting frame.

5. The invention set forth in claim 4, further characterized by means for supporting the body of the patient in a squatting posture when the body of said patient is braced against said bodysupporting frame consisting of a pair of crutch Standards approximately rectangular in crosssection each extending from a side of said bodysupporting frame and having a transverse portion extending inwardly over said body-supporting frame, each of said standards being secured to one of said longitudinal depending bars by a clamp, a combination thigh and knee crutch having a part projecting forwardly from the thighsupporting portion of said crutch and terminating in a ball portion, a pair of adjustable clamps each connecting a ball portion of one of said crutches with its standard, a second pair of crutch standards of approximately circular crosssection each extending from a side of said bodysupporting frame and having a second transverse portion extending inwardly over said body-supporting frame and terminating in a second ball portion, a second pair of clamps each for securing one of said second standards to one of said longitudinal depending bars, a pair of arm braces. a second pair of clamps each extending longitudinally from the underside of one of said arm braces, the outer end of each of said second pair of clamps adjustably engaging one of said second ball portions.

6. The invention set forth in claim 4, further characterized by a foot-supporting member conlsisting of a frame mounted on front and rear pairs of inclined links, the upper ends of said links being pivotally connected to the underside of said frame, angle bars having the lower` ends of said links being pivotally connected thereto, said angle-bars being rigidly connected to form a carriage frame, longitudinal rollways having said carriage frame slidable therein, anti-friction rollers mounted on the inner sides of said front and rear pairs oi vertical plates, rearward projections from said rear pair of inclined links having outwardly projecting roller-equipped studs, and vertically extending arms secured to the outside of said angle-bars adjacent to the lower ends of said rear pair of inclined links.

7. The invention set forth in claim 4, further characterized by means for positioning said footsupporting member consisting of cams secured to the inner sides of said front pair of vertical plates, said cams having open upwardly curved slots engaging the roller-equipped studs projecting outwardly from said rear pair of inclined links for swinging said foot-supporting member to its upper position as said foot-supporting frame emerges from the out-of-way position, and a pair of spring actuated pawls pivotally connected to the inner sides of said longitudinal bars, vertically extending arms secured to the outer sides of the carriage frame of said footsupporting member positioned for being engaged by said pawls and retaining said foot-supporting member in said upper position while said rotatable frame remains in its lower position.

References Cited in the nie of this patent UNITED STATES PATENTS Number Name Date 1,255,322 Laraia Feb. 5, 1918 2,120,732 Comper et al June 14, 1938 2,253,112 DeBoysson Aug. 19, 1941 2,257,491 Armstrong Sept. 30, 1941 2,398,558 Reirnuller Apr. 16, 1946 2,571,829 Buckley Oct. 16, 1951 2,605,151 Shampaine July 29, 1952 

